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General NPI Number Information
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NPI Number | 1144844077
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Entity Type | Individual
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Provider Name | LETTY PROBASCO MD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2020
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 131 COMMONWEALTH DR STE 240
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City | GREENVILLE
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State | SC
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Zip | 29615-5194
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Country | US
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Telephone | 864-297-0080
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Fax | 877-389-6645
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Provider Business Mailing Address
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Address Line | 1200 S CEDAR CREST BLVD
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City | ALLENTOWN
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State | PA
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Zip | 18103-6202
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Country | US
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Telephone | 610-402-9116
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Fax | 610-402-9610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 95195
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT221341
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MT221341
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License Number State | PA
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